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This is VAERS ID 25556

Case Details

VAERS ID: 25556 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:1989-10-20
Onset:1989-10-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Sepsis
SMQs:, Agranulocytosis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1989-10-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC Split Type: WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


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